Confusing effect of concurrent endoscopy and colonoscopy on histopathologic findings in dyspeptic patients: a nested case-control study

F. Mulkut, M. Karahan, G. Okut

General Surgery Department, Health Science University, Istanbul Kartal Lutfu Kırdar City Hospital, Istanbul, Turkey. gokalp.okut@gmail.com

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• Gastroenterology

OBJECTIVE: Esophagogastroduodenoscopy (EGD) is recommended for patients over 60 years old with dyspeptic complaints, treatment-resistant dyspepsia, and alarming symptoms such as vomiting, weight loss, and dysphagia. However, colonoscopy is recommended for patients with abnormal colonic loops in their imaging, lower gastrointestinal bleeding-iron deficiency anemia, or patients with symptoms related to the lower gastrointestinal tract. This study aimed to analyze the possibility of performing concurrent colonoscopy when it is indicated and whether this may affect endoscopic and histological findings.

PATIENTS AND METHODS: One hundred and two patients who underwent EGD and colonoscopy (Group CC) at the same time due to dyspeptic symptoms and 146 patients who underwent EGD alone (Group EA) at SBU Kartal City Hospital between December 2020 and December 2021 were included in the study. All gastric biopsies were taken by the Sydney system. The specimens were assessed in terms of helicobacter pylori positivity, inflammation, neutrophilic activity, intestinal metaplasia, and lymphoid aggregate.

RESULTS: Helicobacter pylori positivity was 46.5% and 50.7% (p=0.521), inflammation was 93.1% and 98.6% (p=0.023), neutrophilic activity was 50.0% and 65.8% (p=0.013), intestinal metaplasia was 20.6% and 24.0% (p=0.531), and the presence of lymphoid aggregate was 46.1% and 58.9% (p=0.046) in Group CC and Group EA, respectively.

CONCLUSIONS: The present study comparatively evaluated the histopathological findings of patients who underwent EGD due to dyspeptic symptoms and those who underwent bidirectional endoscopy. Notably, no false positive results were observed that would necessitate a change in the treatment applied to the patients.

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